Immunize
Palivizumab
search
Palivizumab
, Synagis
See Also
Respiratory Syncytial Virus
Pediatric Vaccination
Bronchopulmonary Dysplasia
Indications
RSV Prophylaxis (AAP guidelines, 2014)
Congenital airway, pulmonary or neuromuscular disorder interfering with secretion clearance in age <12 months
Hemodynamically significant
Congenital Heart Disease
in age <12 months
Severe
Immunodeficiency
in age <24 months
Preterm Infant
s with
Gestational age
at birth <29 weeks and age <12 months
Chronic lung disease of prematurity
Age <12 months
Gestational age
<32 weeks AND
Required
Supplemental Oxygen
>21% for at least 28 days after delivery
Age <24 months
Treatment (oxygen, broncodilators, steroids,
Diuretic
s) within 6 months of RSV season start
Cystic Fibrosis
Age <12 months
Findings of chronic lung disease or nutritional deficiency
Age <24 months
Weight for Length
below 10th percentile OR
Severe lung disease (respiratory related hospitalization in age <1 year or persistent CXR changes)
Mechanism
Humanized mouse
Monoclonal Antibody
to RSV
Provides passive
Immunity
to RSV in high risk infants
Dosing
Palivizumab 15 mg/kg IM monthly for up to 5 months of RSV season
Historically RSV season has been November 1 to March 1 in U.S.
However post-2020 Covid, peak RSV season has shifted to spring-summer
Efficacy
Decreases hospitalizations by 45 to 55%
NNT 18 to prevent one RSV related hospitalization
Does not decrease RSV related mortality
Resources
Palivizumab Injection Solution (DailyMed)
https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=3a0096c7-8139-44cd-bba4-520ab05c2cb2
References
Pickering (2009) Red Book, AAP, Elk Grove Village, p. 560
(2014) Pediatrics 134(2): e620-38 [PubMed]
Gargnani (2021) Cochrane Database Syst Rev 11(11):CD013757 +PMID: 34783356 [PubMed]
Type your search phrase here